Are You TILTed? An Insidious Disease Process Emerges

We live amid a vast array of synthetic organic chemicals — in the air we breathe, in our food and water, and in products we apply to our skin. These chemicals are derived from oil, coal and gas. Most are new since World War II. Over this same time, a new disease process has emerged that is as novel as these modern chemical compounds. “TILT,” or “Toxicant-induced Loss of Tolerance,” is a process that starts with a chemical exposure, such as in a “sick building,” after a chemical spill, or a pesticide exposure. These exposures can cause susceptible individuals to lose their tolerance for many substances that never bothered them previously and do not bother most people.


A recent example took place in the aftermath of the Deepwater Horizon oil spill in the Gulf of Mexico. Clean-up workers reported chronic health problems associated with TILT, including multi-system symptoms (fatigue, sleep problems, headaches, digestive difficulties, and problems with memory and concentration) as well as new intolerances for common chemicals, foods and medications they formerly tolerated. As in earlier petrochemical exposures, e.g., to the Exxon Valdez spill in Alaska, to Gulf War chemicals and oil well fires, and persons exposed to the World Trade Center disaster on 9-11, those affected may suddenly feel dizzy or nauseated around engine exhaust, cleaning chemicals, fragrances, or feel ill after meals, after eating foods they formerly enjoyed, or even drinking a single beer or a glass of wine. These new intolerances are the hallmark symptom of the TILT disease process, just as fever is a hallmark symptom of infectious disease. TILT is difficult to treat, but it can be prevented.

To find out whether you may be susceptible to TILT or to track your symptoms, take the QEESI — a validated and published questionnaire developed by Dr. Claudia Miller that is used by researchers and doctors internationally. Download the QEESI and the professionally acclaimed book as well as other publications by Dr. Miller at no charge under the Publications & Presentations tab on this site. These are provided as a public service to help prevent others from becoming ill.


Interview about household chemicals, KSAT-TV, San Antonio Full Story

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Dr. Claudia Miller
Department of Family & Community Medicine
University of Texas Health Science Center at San Antonio
7703 Floyd Curl Drive (222 MCS)
San Antonio, TX 78229-3900



For information on how you can support Dr. Claudia Miller’s research, please contact Ms. Kim Warshauer in the Office of Development at